How to avoid gluten if you have celiac disease

Doctors treat celiac disease with a gluten-free diet. Gluten is a protein found naturally in wheat, barley, and rye that triggers a reaction if you have celiac disease.

Symptoms greatly improve for most people with celiac disease who stick to a gluten-free diet.

In recent years, grocery stores and restaurants have added many more gluten-free foods and products, making it easier to stay gluten free.

Your doctor may refer you to a dietitian who specializes in treating people with celiac disease. The dietitian will teach you how to avoid gluten while following a healthy diet. He or she will help you

check food and product labels for gluten

design everyday meal plans

make healthy choices about the types of foods to eat

For most people, following a gluten-free diet will heal damage in the small intestine and prevent more damage. You may see symptoms improve within days to weeks of starting the diet.

The small intestine usually heals in 3 to 6 months in children. Complete healing can take several years in adults.

Once the intestine heals, the villi, which were damaged by the disease, regrow and will absorb nutrients from food into the bloodstream normally.

Gluten-free diet and dermatitis herpetiformis

If you have dermatitis herpetiformis—an itchy, blistering skin rash—skin symptoms generally respond to a gluten-free diet. However, skin symptoms may return if you add gluten back into your diet.

Medicines such as dapsone, taken by mouth, can control the skin symptoms. People who take dapsone need to have regular blood tests to check for side effects from the medicine.

Dapsone does not treat intestinal symptoms or damage, which is why you should stay on a gluten-free diet if you have the rash.

Even when you follow a gluten-free diet, the rash may take months or even years to fully heal—and often comes back over the years.

Avoiding medicines and nonfood products that may contain gluten

In addition to prescribing a gluten-free diet, your doctor will want you to avoid all hidden sources of gluten. If you have celiac disease, ask a pharmacist about ingredients in

herbal and nutritional supplements

prescription and over-the-counter medicines

vitamin and mineral supplements

You also could take in or transfer from your hands to your mouth other products that contain gluten without knowing it. Products that may contain gluten include

children’s modeling dough, such as Play-Doh

cosmetics

lipstick, lip gloss, and lip balm

skin and hair products

toothpaste and mouthwash

communion wafers

Medications are rare sources of gluten. Even if gluten is present in a medicine, it is likely to be in such small quantities that it would not cause any symptoms.

Reading product labels can sometimes help you avoid gluten. Some product makers label their products as being gluten-free.

If a product label doesn’t list the product’s ingredients, ask the maker of the product for an ingredients list.

What if changing to a gluten-free diet isn’t working?

If you don’t improve after starting a gluten-free diet, you may still be eating or using small amounts of gluten.

You probably will start responding to the gluten-free diet once you find and cut out all hidden sources of gluten. Hidden sources of gluten include additives made with wheat, such as

modified food starch

malt flavoring

preservatives

stabilizers

If you still have symptoms even after changing your diet, you may have other conditions or disorders that are more common with celiac disease, such as irritable bowel syndrome (IBS), lactose intolerance, microscopic colitis, dysfunction of the pancreas, and small intestinal bacterial overgrowth.